| NPI | 1508228859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35.143066) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM 1508228859) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2021-08-12 |