| NPI | 1487094082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: NY 284844) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036148738) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: IL 036148738) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2020-07-27 |