| NPI | 1972998730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 88978) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 04315) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 88978) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-09-09 |