| NPI | 1154647352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NC 2013-00386) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2013-00386) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: NC 2013-00386) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2019-06-26 |