| NPI | 1073630893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH OH 35093594) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R1428) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2020-12-29 |