| NPI | 1215137542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: WA MD60320115) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60320115) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: WA MD60320115) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2013-06-28 |