| NPI | 1003444902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 95043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 95043) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 95043) | |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2026-08-26 |