| NPI | 1205241270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 53319) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 53319) |
| 282N00000X General Acute Care Hospital (Licence: AZ R74579) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 53319) | |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2025-08-02 |