| NPI | 1487693271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.005495) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34005495) |
| 207Q00000X Family Medicine (Licence: PA OS012515) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-11-19 |