| NPI | 1700922143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: WA MD 49451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD24955) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: WA MD 49451) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2014-12-29 |