| NPI | 1629507140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35.149626) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 259741) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301112339) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2024-05-16 |