NPI | 1740423250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 13723) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-092920) |
Enumeration Date | 2009-04-14 |
Last Update Date | 2024-04-10 |