| NPI | 1457880460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 036.156048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA md470387) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT213491) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2023-04-11 |