| NPI | 1396718672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35089459) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD02934OE) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2012-08-24 |