| NPI | 1720427719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MT MED-PHYS-LIC-87791) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 19252) |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2020-07-01 |