| NPI | 1255488060 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 62617) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 62617) | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.121875) | |
| Enumeration Date | 2007-01-04 | 
| Last Update Date | 2019-09-30 |