| NPI | 1932562899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.013041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02007688A) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IN 02007688A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-05-20 |