| NPI | 1881770774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD 00048007) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-115541) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD 00048007) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2011-04-28 |