| NPI | 1750349528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35068887) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO 2004003090) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME101704) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2019-05-07 |