| NPI | 1023033479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-05-3127) |
| Additional Taxonomies | 101200000X Drama Therapist (Licence: OH 35-05-3127) |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: OH 35053127) | |
| 207L00000X Anesthesiology (Licence: OH 35-05-3127) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-03-28 |