| NPI | 1619361045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 77458) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 303922) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63585) | |
| 207R00000X Internal Medicine (Licence: NY 303922) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2024-09-09 |