| NPI | 1073954285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 88149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.127172) |
| 207R00000X Internal Medicine (Licence: OH 57.022412) | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2021-10-27 |