| NPI | 1104261445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: KY 50868) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: TN 55687) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2018-09-26 |