| NPI | 1003243213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD473833) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT211206) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101273124) | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2021-10-26 |