| NPI | 1134418908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 63488) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD21404) |
| 207R00000X Internal Medicine (Licence: NY 273595) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ME MD21404) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 273595) | |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2020-10-07 |