| NPI | 1235792342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.152761) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2022-02819) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2025-03-07 |