| NPI | 1366655656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 34.003736) |
| Additional Taxonomies | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: OH 34.003736) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2015-09-02 |