| NPI | 1003134222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: PA MD448675) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 50455) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2020-08-17 |