| NPI | 1528700630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MT237321) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 336584) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT237321) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MT237321) | |
| Enumeration Date | 2022-04-09 |
| Last Update Date | 2026-06-08 |