| NPI | 1235585985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35.134916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.134916) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 35.134916) | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2023-06-21 |