| NPI | 1982761060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35-058433) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: OH 35058433) |
| 208D00000X General Practice (Licence: OH 35058433) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2024-01-30 |