| NPI | 1205047255 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P5348) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.084736) | 
| 207Q00000X Family Medicine (Licence: NY 236617) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: NY 236617) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: OH 35.084736) | |
| Enumeration Date | 2007-05-24 | 
| Last Update Date | 2019-06-25 |