| NPI | 1346656741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY C3698) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.130271) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2025-08-18 |