| NPI | 1407110356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD060839384) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD060839384) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD060839384) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD176712) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2018-05-09 |