| NPI | 1942565841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.149489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301101057) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036138396) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 51618) | |
| Enumeration Date | 2012-07-08 |
| Last Update Date | 2023-12-14 |