| NPI | 1649251125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 36425) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 200101198) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 200101198) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2026-05-18 |