| NPI | 1316010275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G79699) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G79699) |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA G79699) | |
| 103K00000X Behavior Analyst (Licence: CA 1-25-83284) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2026-05-05 |