| NPI | 1013470863 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: UT 14211602-1205) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 71614) | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: UT 14211602-1205) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-09 | 
| Last Update Date | 2025-03-26 |