| NPI | 1245338185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD190812) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35076837) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 335076837) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-11-06 |