| NPI | 1790050995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 271439) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 271439) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 271439) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2024-10-24 |