| NPI | 1295183465 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 49406) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 65662-20) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35128915) | |
| Enumeration Date | 2016-05-29 |
| Last Update Date | 2022-10-26 |