| NPI | 1790198679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GU M-2265) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GU EMTL-2021-008) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GU M-2265) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GU EMTL-2021-008) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2021-07-19 |