| NPI | 1659932341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AL 49729) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 64125) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN34399) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2025-03-18 |