| NPI | 1053817999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AR E-13642) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AR E-13642) |
| 208000000X Pediatrics (Licence: AR E-13642) | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2025-08-03 |