| NPI | 1871799742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: OH 35.094818) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301089677) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35.094818) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2013-07-01 |