| NPI | 1982993606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD60403111) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60403111) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2021-05-18 |