| 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 |