| NPI | 1366962656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX T6906) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NC 2024-00649) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2024-07-12 |