| NPI | 1063654309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: FL ME122607) |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease (Licence: GU M-1886) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2022-01-27 |