| NPI | 1245347434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD11508) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD00030875) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-15 |