| NPI | 1861685356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 275910) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 275910) | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2014-07-08 |