| NPI | 1053725200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 303943) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042.0014054) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2024-06-03 |