| NPI | 1366856874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 303509) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 61669) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 303509) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2021-11-19 |