NPI | 1336642099 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2024-00745) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-03-08 |
Last Update Date | 2024-09-13 |