| NPI | 1750542015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: FL me151117) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX 45614) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2021-07-01 |