| NPI | 1376812065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 278045) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 54998) |
| 207R00000X Internal Medicine (Licence: MA 278045) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-12-25 |
| Last Update Date | 2019-05-28 |