| NPI | 1861017261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.156663) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.156663) |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2026-08-26 |