| NPI | 1679572317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35-028167) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 28167) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35-028167) | |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2012-05-16 |