| NPI | 1245218478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34006156C) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA 05008296L) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 34006156C) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PA 05008296L) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2008-09-22 |