| NPI | 1295184950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD473485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 276897) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 268052) | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2022-06-29 |