| NPI | 1265786552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G63126) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G63126) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CO 27589) | |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2025-01-13 |