| NPI | 1528645207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 1023213) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2026-09-14 |