| NPI | 1689802480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: KY 53511) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 2014-01695) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WV 30933) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2014-01695) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2025-05-05 |