| NPI | 1548252901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OH 35069408) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35069408) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: OH 35069408) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2022-05-20 |