| NPI | 1467913871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: VA 0101272575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116034868) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: VA 0101272575) | |
| 208D00000X General Practice (Licence: VA 0116034868) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-07-28 |