| NPI | 1083091771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T0718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A146180) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A146180) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 146180) | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2021-07-07 |