| NPI | 1962610972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease (Licence: VA 0101245621) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116018232) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2012-08-14 |