| NPI | 1528294139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 2698908) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.125626) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2022-02-10 |