NPI | 1548292519 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 61-21847) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34-00-4435-B) |
207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: OH 34.007735) | |
207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 34.007735) | |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OH 34.007735) | |
Enumeration Date | 2006-07-07 |
Last Update Date | 2022-05-20 |