| NPI | 1578555769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35-078091B) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.078091) |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: OH 35-078091) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2024-03-25 |