| NPI | 1689036139 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A168403) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD192629) | 
| 207R00000X Internal Medicine (Licence: CA A168403) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036164481) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-23 | 
| Last Update Date | 2024-09-04 |