| NPI | 1366690844 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MO 2012034336) | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 53446) | 
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 104898) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-09-08 | 
| Last Update Date | 2021-11-12 |