| NPI | 1679867873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MD D83200) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2022-06-21 |