NPI | 1538455720 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 34.010695) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 54259) |
207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 34.010695) | |
208D00000X General Practice (Licence: OH 34.010695) | |
Enumeration Date | 2011-06-26 |
Last Update Date | 2022-04-06 |