| NPI | 1144889080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.152736) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.248271) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2025-08-05 |