| NPI | 1124084819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 000439) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CT 000439) |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2026-04-16 |