| NPI | 1063770014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.122649) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: WV 26137) |
| 207Q00000X Family Medicine (Licence: KY 47451) | |
| 207Q00000X Family Medicine (Licence: WV 26137) | |
| 208M00000X Hospitalist (Licence: WV 26137) | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2024-02-14 |