| NPI | 1942395546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.084518) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.084518) |
| 207P00000X Emergency Medicine (Licence: IL 036.167407) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-09-15 |