| NPI | 1871586776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA 25328) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA 25328) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA 25328) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2015-03-13 |