| NPI | 1154783645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CO DR.0069031) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A152992) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2022-10-14 |