| NPI | 1558746321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MI 5315241403) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.145173) |
| 207R00000X Internal Medicine (Licence: CT 57033) | |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2024-10-10 |