| NPI | 1245402320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD186984) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35097424) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO 0053377) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2021-09-13 |