NPI | 1982648507 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35053630) |
Additional Taxonomies | 174400000X Specialist (Licence: OH 35053630) |
Enumeration Date | 2006-06-15 |
Last Update Date | 2021-09-24 |