| NPI | 1164623815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.128640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME104077) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2018-10-11 |