| NPI | 1124033790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.127530) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301063517) |
| 207R00000X Internal Medicine (Licence: OH 35.127530) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2022-09-16 |