| NPI | 1063907111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2024-00256) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2024-00256) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 276646) | |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2024-05-31 |