| NPI | 1851753545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A157313) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A157313) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A157313) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: NV 24275) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A157313) | |
| 207R00000X Internal Medicine (Licence: NV 24275) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV 24275) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NV 24275) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-12-23 |