| NPI | 1801257712 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD210296) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A154233) | 
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD210296) | |
| Enumeration Date | 2016-03-19 | 
| Last Update Date | 2023-12-06 |