| NPI | 1760036065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: ND 20924) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 279918) |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2024-07-27 |