| NPI | 1457594897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35099669) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 52830) |
| 207R00000X Internal Medicine (Licence: VA 0101251931) | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2022-07-21 |