NPI | 1013262690 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.144196) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0079468) |
207R00000X Internal Medicine (Licence: KY 50515) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT201895) | |
Enumeration Date | 2012-07-19 |
Last Update Date | 2022-05-24 |