| NPI | 1801803390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00025682) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD00025682) |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: WA MD00025682) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2016-10-25 |