| NPI | 1912356106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV SL1151) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NV DO2560) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV DO2560) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2026-07-30 |