| NPI | 1033793161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AL 48916) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-10821) |
| 207R00000X Internal Medicine (Licence: MO 2021023174) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2024-10-10 |