| NPI | 1235420837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: OH 35-123179) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-123179) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2019-01-15 |