| NPI | 1235686601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PR 22164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 32437) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PR 22164) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 33574) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 33196) | |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2023-01-12 |