| NPI | 1649262171 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD00031478)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00031478)  | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD00031478)  | |
| Enumeration Date | 2005-08-19 | 
| Last Update Date | 2010-06-09 |