| NPI | 1700095494 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60448453) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IA 38422) | 
| 207R00000X Internal Medicine (Licence: IA 38422) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA 38422) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD60448453) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD60448453) | |
| Enumeration Date | 2007-05-21 | 
| Last Update Date | 2015-10-21 |