| NPI | 1760466726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: KY C2689) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01066636A) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35.120207) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2024-07-15 |