NPI | 1821529652 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 70643) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 302603) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-03-23 |
Last Update Date | 2023-10-27 |