| NPI | 1285082230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 292681) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD476801) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT211393) | |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2022-08-24 |