| NPI | 1023403052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD61095333) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61095333) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2021-06-30 |