| NPI | 1578904884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: WI 70629-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 011622) |
| 207R00000X Internal Medicine (Licence: MI 5101022450) | |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2019-06-26 |