| NPI | 1861771370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX T4815) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301098577) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NC 228407) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301098577) | |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2022-06-07 |