| 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 |