| NPI | 1689758500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.130016) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.130016) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2023-12-07 |