| NPI | 1508124900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 312424) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA 312424) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 4301115943) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA 312424) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2019-07-31 |