| NPI | 1225087760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2007-00565) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35071019) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 20695) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2022-08-04 |