| NPI | 1417972308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.120561) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI SR075015) |
| 207R00000X Internal Medicine (Licence: MI 4301075015) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2021-07-08 |