| NPI | 1134474109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.132809) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.060877) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 63821) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2021-06-01 |