NPI | 1114187119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 247693) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ND 14298) |
207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH OH34.012440) | |
Enumeration Date | 2008-06-12 |
Last Update Date | 2023-05-23 |