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 |