| NPI | 1235262668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD60012991) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35089055) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2015-09-10 |