| NPI | 1730132580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-08-2167) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 21526) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35-08-2167) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 21526) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: OH 35-08-2167) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: WV 21526) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2013-08-14 |