| NPI | 1063874667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A150814) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A150814) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A150814) | |
| 207RS0012X Internal Medicine, Sleep Medicine (Licence: CA A150814) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2022-05-05 |