| NPI | 1790724318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35082048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35082048) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35-08-2048) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2011-11-28 |