| 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 |