| NPI | 1225281033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MT 28024) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MT 28024) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MT 28024) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MT 28024) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN # 11611) | |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2022-02-24 |