| NPI | 1194335505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 76637) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.249247) |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2024-10-21 |