| NPI | 1952823254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 57437) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 57437) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 63944) | |
| Enumeration Date | 2017-07-09 |
| Last Update Date | 2023-06-21 |