| NPI | 1376512426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 35.069807) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35-069807) |
| 207Q00000X Family Medicine (Licence: OH 35.069807) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2025-06-18 |