| NPI | 1962706564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA 60665909) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA 60665909) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2017-08-02 |