| NPI | 1811423775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A158200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A158200) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A158200) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-01-24 |