| NPI | 1518306471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 51963) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301102716) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.137176) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2021-11-30 |