| NPI | 1336604297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 7491920) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WI 74919-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: WI 7491920) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 7491920) | |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2025-07-18 |