| NPI | 1598776072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 35081889) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35081889) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2021-12-27 |