| NPI | 1659669000 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.130365)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.134780)  | 
| Enumeration Date | 2011-07-19 | 
| Last Update Date | 2024-04-30 |