NPI | 1801030275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD 60071840) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.012226) |
Enumeration Date | 2009-04-28 |
Last Update Date | 2010-12-13 |