| NPI | 1689863953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OK 30429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57013079) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OK 30429) | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2017-09-25 |