| NPI | 1962491613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35-084716) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-084716) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2018-03-17 |