| NPI | 1245717909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IN 01096431A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072953) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301507051) | |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2025-08-27 |