| NPI | 1386106557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO DR0070870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61204349) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2023-06-21 |