NPI | 1952424657 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR0058636) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.001782) |
207R00000X Internal Medicine (Licence: AR E5527) | |
Enumeration Date | 2007-04-09 |
Last Update Date | 2017-05-22 |