| NPI | 1750815700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: AZ 61026) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10074236) |
| 207R00000X Internal Medicine (Licence: AZ 61026) | |
| 207R00000X Internal Medicine (Licence: AZ R76038) | |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2023-10-23 |