| NPI | 1386812451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35046345-W) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 046345) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2016-06-07 |