| NPI | 1629334669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 58004312) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MI 5101024375) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2024-08-02 |