| NPI | 1710277082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA OP60725438) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP60725438) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2017-06-09 |