| NPI | 1598082877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35123685) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY TP612) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35121267) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY TP612) | |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2019-07-27 |