| NPI | 1750450177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA A95770) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A95770) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A95770) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2025-10-27 |