| NPI | 1679962419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD70030839) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD70030839) |
| 207R00000X Internal Medicine (Licence: GA 83785) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 83785) | |
| 207R00000X Internal Medicine (Licence: WA MD70030839) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 83785) | |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2026-02-09 |