| NPI | 1609286590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 71809) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: KS 94-09344) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2023-03-21 |