| NPI | 1770534497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35-07-6701) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 18878) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-10-26 |