| NPI | 1013460500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 65567) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.027856) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2023-12-11 |