| NPI | 1487033486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 87861) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME142615) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 21405) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 87861) | |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2022-07-08 |