| NPI | 1396159687 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.131335) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105902) | 
| Enumeration Date | 2014-06-16 | 
| Last Update Date | 2025-05-19 |