| NPI | 1366684896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 259676) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 259676) | |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2015-05-12 |