| NPI | 1609959865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35-125407) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 41324) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2021-01-12 |