| NPI | 1285837500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.090377) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57-009684) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2010-04-19 |