| NPI | 1104001031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX Q5785) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125048872) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AR E7004) | |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2015-11-10 |