| NPI | 1023215803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 34.010825) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101017319) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2013-07-26 |