| NPI | 1811159239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 71295) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: SC 38017) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2021-04-26 |