| NPI | 1588705537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.003913) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34 003913) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 34 003913) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2012-06-07 |