| NPI | 1215912068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35047809) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35047809U) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35047809) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2022-11-09 |