NPI | 1861416281 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 1001) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34008521) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2011-03-30 |