| NPI | 1154647568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IA MD-41368) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2012014712) | |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2016-08-19 |