| NPI | 1356874358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35.138724) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.138724) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2026-06-24 |