| NPI | 1992010565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 61950) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 075727) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 290678) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 61950) | |
| Enumeration Date | 2010-08-08 |
| Last Update Date | 2022-07-25 |