| NPI | 1447697404 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD462948) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD462948) | 
| 207R00000X Internal Medicine (Licence: PA MT210224) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD462948) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301103230) | |
| Enumeration Date | 2013-05-31 | 
| Last Update Date | 2021-08-04 |