| NPI | 1609079540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 42528) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 42528) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 57006900) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2018-09-12 |