| NPI | 1023366671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35.147930) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD465723) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2023-06-15 |