| NPI | 1588719686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD60688548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60688548) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR md12347) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2022-10-11 |