| NPI | 1518064302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 12525) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 146534) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.155011) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2026-03-05 |