| NPI | 1174055149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA 20A16871) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2022013108) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2023-07-17 |