| NPI | 1912346347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NE 1314) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WI 76115) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2021-10-13 |