| NPI | 1053360057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD60346379) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GU MD-P-2023-001) |
| 208D00000X General Practice (Licence: WA MD60346379) | |
| 208D00000X General Practice (Licence: AL 00027000) | |
| 207R00000X Internal Medicine (Licence: WA MD60346379) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2024-08-15 |