| NPI | 1982233953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR PG216180) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.250174) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2023-07-12 |