| NPI | 1760643027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: TN 47966) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: TN 47966) | |
| 207R00000X Internal Medicine (Licence: AL 29892) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2015-07-31 |