NPI | 1760469837 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35054254S) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35054254S) |
Enumeration Date | 2005-12-29 |
Last Update Date | 2019-10-18 |