| NPI | 1487602637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35132221) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 156903) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 046717) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-01-10 |