| NPI | 1699749069 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 89373) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101239063) | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 89373) | |
| Enumeration Date | 2006-02-14 | 
| Last Update Date | 2025-01-16 |