| NPI | 1093343899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 34.016422) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.106422) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2025-07-30 |