| NPI | 1114126943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2014007846) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.009866) |
| 207R00000X Internal Medicine (Licence: NC 2009-01056) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 3571 M31) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2022-01-28 |