| NPI | 1992291652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61608202) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD61608202) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC MD210002096) | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2025-07-09 |