| NPI | 1477660637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2003008345) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35C.004114) |
| 207P00000X Emergency Medicine (Licence: AR E-9420) | |
| 207R00000X Internal Medicine (Licence: AR E-9420) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2026-05-27 |