| NPI | 1831521764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 52293) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.127861) |
| 207R00000X Internal Medicine (Licence: MI 4301103185) | |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2022-06-27 |