| NPI | 1174634737 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ID M-11159) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.086707) | 
| 207R00000X Internal Medicine (Licence: ID M11159) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: ID M-11159) | |
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2017-12-08 |