| NPI | 1467656686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OK 33514) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 26645) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2021-11-10 |