| NPI | 1174105100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX BP10087102) |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2024-06-19 |