| NPI | 1104387398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA SP034500) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 34.015784) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 34.015784) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2026-07-16 |