| NPI | 1629697842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 81419-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.015823) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2024-06-25 |