| NPI | 1053517540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 24151) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 24151) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2012-12-03 |