| NPI | 1487773842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 47928) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.088250) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: OH 35088250) | |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35088250) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2017-04-17 |