| NPI | 1811457674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AZ 75978) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2022024150) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-04-28 |