NPI | 1922387588 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 57019149) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 57067) |
Enumeration Date | 2011-08-12 |
Last Update Date | 2022-10-27 |