| NPI | 1154907723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.151112) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.151112) | |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2024-12-02 |