| NPI | 1851787402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TN 67116) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57026550) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2023-05-11 |