| NPI | 1518952605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35076719) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH OH35-07-6719) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2009-05-07 |