| 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 |