| NPI | 1629237458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 45376) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11013109A) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2023-09-28 |