| NPI | 1134323884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101263145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2011-00523) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D0084467) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-08-11 |