| NPI | 1104887413 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 34005079)  | 
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA OS008928L)  | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 34005079)  | |
| Enumeration Date | 2006-03-28 | 
| Last Update Date | 2011-08-05 |