| NPI | 1255415170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-095246) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35-095246) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 94-00364) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-12-05 |