| NPI | 1942205208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 5101009355) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 5101009355) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 34.008398) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 34.008398) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2023-11-03 |