| NPI | 1598028433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101255210) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101255210) |
| 208D00000X General Practice (Licence: VA 0101255210) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0101255210) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2018-04-11 |