| NPI | 1083001119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD470247) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA 28278737) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2020-12-03 |