| NPI | 1720027808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35121891) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: IL 036-111260) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2014-10-01 |