| NPI | 1821329301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.097495) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC 36852) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2017-04-18 |