| NPI | 1720498645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A144698) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME139231) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A144698) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A144698) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME139231) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME132493) | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2026-05-29 |