NPI | 1730230376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OH 35.048491) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: OH 35.048491) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2023-03-07 |