| NPI | 1902295694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CO DR.0065825) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD60846635) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD60846635) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO DR.0065825) | |
| Enumeration Date | 2015-01-18 |
| Last Update Date | 2021-07-06 |