| NPI | 1972890606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01078956A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57-) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2021-10-11 |