| NPI | 1366785206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T3128) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.012126) |
| 207R00000X Internal Medicine (Licence: IL 036148786) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036148786) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2022-05-11 |