| NPI | 1811135379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2018-01361) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: ND 13147) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2023-08-23 |