| NPI | 1659531747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 70034) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD434851) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT186542) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2021-08-18 |