| NPI | 1225298029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 73741) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 051439) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: MN 105563) | |
| 207R00000X Internal Medicine (Licence: MN 54415) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 73471) | |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2019-10-03 |