| NPI | 1669675534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA 60085897) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60085897) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2013-07-03 |