| NPI | 1104359264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101268928) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D0097591) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D0097591) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2023-05-24 |