| NPI | 1043741259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 95602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 272394) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 95602) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 272394) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2024-05-08 |