| NPI | 1124187695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 071977) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.063135) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2015-07-31 |