NPI | 1750479143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me98682) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.009156) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2016-01-12 |