| NPI | 1740714682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD470876) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MD470876) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2025-09-02 |