| NPI | 1407167323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 61374) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 0436736) |
| 207R00000X Internal Medicine (Licence: OH 35123512) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2024-05-01 |