| NPI | 1831355882 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 4301103150) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.092806) | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME155100) | |
| Enumeration Date | 2008-07-30 | 
| Last Update Date | 2023-04-24 |