| NPI | 1043455215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: IA 42015) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: IA 42015) | |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2014-10-15 |