| NPI | 1386784270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 35.066999) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.066999) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2022-12-06 |