| NPI | 1417397688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.130925) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.139998) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.130925) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036139998) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036139998) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2022-04-08 |