| NPI | 1710278718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD166439) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 59104) | |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2026-03-09 |