| NPI | 1306367487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 67528) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 67528) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 67528) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351031066) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2023-06-16 |