| NPI | 1205218369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX W0301) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX W0301) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2025-09-26 |