| NPI | 1679993562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO DR.0074494) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NE 1453) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX T2813) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T2813) | |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2025-05-19 |