NPI | 1912170721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.093549) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OH 35.093549) |
207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OH 35.093549) | |
Enumeration Date | 2008-04-12 |
Last Update Date | 2023-01-10 |