NPI | 1548822588 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 76789-20) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.247165) |
Enumeration Date | 2019-06-30 |
Last Update Date | 2024-07-08 |