| NPI | 1245625979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 34.012840) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102205996) |
| 207R00000X Internal Medicine (Licence: OH 34.012840) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 34.012840) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116032511) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2023-03-15 |