| NPI | 1891960316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 247797) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35.086359) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2009-12-16 |