| NPI | 1023450988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 1.066404) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 1.063425-RES) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 1.063425-RES) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 1.063425-RES) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-20 |
| Last Update Date | 2020-09-09 |