| NPI | 1205868908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 34.005240) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: OH 34.005240) |
| 208600000X Surgery (Licence: OH 34005240) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2024-06-03 |