| NPI | 1295141802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2024039225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.025370) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2024-12-06 |