| NPI | 1720170947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 17475) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35065548L) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 27503) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-10-16 |