| NPI | 1871018150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: LA 336431) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020032352) |
| 207R00000X Internal Medicine (Licence: LA 336431) | |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: LA 336431) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2023-05-24 |