| NPI | 1205887320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 35.069187) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35069187) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2024-01-18 |