| NPI | 1841579661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA 20A14032) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD H84872) |
| 207T00000X Neurological Surgery (Licence: PA OT013960) | |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2023-11-27 |