| NPI | 1639121098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: OH 35.141901) |
| Additional Taxonomies | 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: ID M9371) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-09-15 |