| NPI | 1942572680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CA A123646) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A123646) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 113908) | |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2021-05-04 |