| NPI | 1114970654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 35.067353) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35067353) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-06-12 |