| NPI | 1316148794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2013-01160) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2013-01160) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD P19906) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL MD.31091) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2019-03-08 |