| NPI | 1578903506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN28311) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 66816) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2020-07-02 |