NPI | 1760489322 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34005250B) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 34005250B) |
Enumeration Date | 2005-06-28 |
Last Update Date | 2009-01-27 |