| NPI | 1124244389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA MD205412) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 046595) |
| 207R00000X Internal Medicine (Licence: MD D0065819) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 046595) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2012-12-18 |