| NPI | 1487095089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T9545) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.136759) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2022-10-12 |