| NPI | 1366882615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 34.014582) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG172035) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2021-03-19 |