| NPI | 1053685107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD61169747) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA BC61190205) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA BC61190205) | |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2024-02-01 |