| NPI | 1659475135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.156300) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.156300) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TN 54053) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 54053) | |
| 207R00000X Internal Medicine (Licence: TN 54053) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2026-06-30 |