| NPI | 1659858942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MI 4351033551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301115375) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: MI 4351033551) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301115375) | |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2024-06-27 |