| NPI | 1114218070 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD202240) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD202240) | 
| 207R00000X Internal Medicine (Licence: WA MD61154902) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD202240) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD61154902) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD61154902) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX S1245) | |
| Enumeration Date | 2011-04-27 | 
| Last Update Date | 2025-03-01 |