| NPI | 1871869420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD60840092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60840092) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2021-12-03 |