| NPI | 1558853689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX V8868) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 34C.000563) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX V8868) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ME DO3017) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2026-04-28 |