| NPI | 1912199712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A107284) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A107284) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2025-04-08 |