| NPI | 1790853216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NV 16722) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 38039) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 38039) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2018-01-09 |