| NPI | 1245506237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD60929341) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD60929341) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD192177) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD192177) | |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2020-05-18 |