| NPI | 1316213895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME122870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME122870) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2025-02-13 |