| NPI | 1679014955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 89136) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 89136) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-11-16 |