| NPI | 1578828224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA OP60949997) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP60949997) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA OP60949997) | |
| 208600000X Surgery (Licence: MI 5101019956) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2021-07-09 |