| NPI | 1629496658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME144292) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME144292) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63412) | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2021-01-07 |