| NPI | 1669905865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX U6667) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301500607) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301500607) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2024-08-17 |