| NPI | 1164403317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-053945) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35.053945) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2018-06-12 |