| NPI | 1932163698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OH 34 005285) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.005285) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2012-08-13 |