| NPI | 1083617724 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35-047519)  | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35-047519)  | 
| Enumeration Date | 2005-05-26 | 
| Last Update Date | 2011-01-05 |