| NPI | 1619010980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35-06-5142-S) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD-046688-L) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 17373) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-12-28 |