| NPI | 1902242605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD61004382) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD61004382) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SD 11291) | |
| 207R00000X Internal Medicine (Licence: WA MD61004382) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2021-10-01 |