| NPI | 1316209018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 35.127178) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.127178) |
| Enumeration Date | 2012-06-09 |
| Last Update Date | 2024-04-15 |