| NPI | 1003234055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301105379) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.133141) |
| 207R00000X Internal Medicine (Licence: MI 4301105379) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.133141) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2024-02-27 |