| NPI | 1306257209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA 312328) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME129292) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2022-08-22 |