| NPI | 1538655501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: PA OS020207) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA HS000054L) |
| 207R00000X Internal Medicine (Licence: PA OS020207) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2024-08-08 |