| NPI | 1205217908 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX T7573) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101261654) | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101261654) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T7573) | |
| Enumeration Date | 2015-06-18 | 
| Last Update Date | 2024-06-10 |