| NPI | 1710205471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 258000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD446651) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197113) | |
| 207R00000X Internal Medicine (Licence: PA MT197113) | |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2018-05-11 |