| NPI | 1225097462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34-005111) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34-005111) |
| 207Q00000X Family Medicine (Licence: WV 1369) | |
| 207Q00000X Family Medicine (Licence: MO 2021043374) | |
| 207Q00000X Family Medicine (Licence: WA OP61229563) | |
| 207Q00000X Family Medicine (Licence: TN DO0000004884) | |
| 207Q00000X Family Medicine (Licence: CA 20A15389) | |
| 207Q00000X Family Medicine (Licence: FL OS8855) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2024-03-13 |