| NPI | 1922084862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35132911) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01072545A) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-09-23 |