| NPI | 1760985121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.014237) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 3525) |
| 207R00000X Internal Medicine (Licence: PA OS021665) | |
| 207R00000X Internal Medicine (Licence: OH 34.014237) | |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2023-07-10 |