NPI | 1700129780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL ME135268) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-03-28 |
Last Update Date | 2022-11-03 |