| NPI | 1376554170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA G39270) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G39270) |
| 207R00000X Internal Medicine (Licence: WA MD 15863) | |
| 207R00000X Internal Medicine (Licence: OR MD 11957) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA G39270) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD 15863) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD 11957) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD 15863) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD 11957) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-08-20 |