| NPI | 1205105525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 58981) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 58981) |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2026-10-01 |