| NPI | 1841295870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: WA MD00047370) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD14316) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2011-01-11 |