| NPI | 1730408212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 069559) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35127680) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN15092) | |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2021-04-26 |