| NPI | 1700225075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.149961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103076) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 82785) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2024-05-16 |