| NPI | 1174733950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME108194) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57011044) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 51306) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-09-15 |