NPI | 1104222603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35135704) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.024138) |
Enumeration Date | 2014-11-10 |
Last Update Date | 2019-11-13 |