| NPI | 1619233723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 52259) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.021073) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 52259) | |
| 208000000X Pediatrics (Licence: OH 57.021073) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2021-01-26 |