NPI | 1063958114 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 29245) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 29245) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-01-12 |
Last Update Date | 2020-06-18 |