NPI | 1669826152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 307592) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT211010) | |
Enumeration Date | 2016-04-20 |
Last Update Date | 2022-09-14 |