| NPI | 1881940476 |
|---|---|
| Other Name | N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301113473) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301113473) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 4301113473) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP2-0037558) | |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2019-01-30 |