| NPI | 1063853109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A162108) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A162108) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A162108) | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2025-09-02 |