| NPI | 1952385643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 3507-5444W) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME100883) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2009-03-12 |