| NPI | 1487911012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: NJ 25MB10117100) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT014442) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2020-09-17 |