NPI | 1275977753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD H97774) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 24831) |
207R00000X Internal Medicine (Licence: PA OT015115) | |
207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA OS020325) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-26 |
Last Update Date | 2023-09-18 |