| NPI | 1679734610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: OH 35.140686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 39503) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: VA 0101255766) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2022-01-25 |