| NPI | 1679816094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101269599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101269599) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101269599) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2020-06-13 |