| NPI | 1386023471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T0236) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T0236) |
| 207R00000X Internal Medicine (Licence: OH 57.026494) | |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2023-06-28 |