| NPI | 1871931501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.131212) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 256570) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2019-05-10 |