| NPI | 1942300405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00047736) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD00047736) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD00047736) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-02-13 |