| NPI | 1053549121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036129569) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-056542) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036129569) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 57095-20) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2015-07-30 |