| NPI | 1962708552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: OH 35-129849) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 26994) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35-129849) | |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: NE 26994) | |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: NE 26994) | |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: KY 50448) | |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2023-03-27 |