| NPI | 1669429908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2012021377) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.009566) |
| 207R00000X Internal Medicine (Licence: OH 34.009566) | |
| 208M00000X Hospitalist (Licence: MO 2012021377) | |
| 202C00000X Independent Medical Examiner (Licence: MO 2012021377) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2024-10-17 |