| NPI | 1518171644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.022740) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OH 35 022740) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35 022740) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2013-05-20 |