| NPI | 1093912545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 38674) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101247232) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2015-08-03 |