| NPI | 1811199243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35.096490) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2005020851) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2023-10-19 |