| NPI | 1558773713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CO DR0066362) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 27746) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2025-02-27 |