| NPI | 1346536554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX R6381) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R6381) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX R6381) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT014181) | |
| 207R00000X Internal Medicine (Licence: PA OS017848) | |
| Enumeration Date | 2011-06-26 |
| Last Update Date | 2021-08-10 |