| NPI | 1497958193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD H0071926) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.002312) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2014-09-24 |