| NPI | 1528097995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35092202) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.092202) |
| 207P00000X Emergency Medicine (Licence: OH 35092202) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2025-08-11 |