| NPI | 1487273900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD493571) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.149838) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2026-07-16 |