| NPI | 1760911002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX T6038) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301112135) |
| 207R00000X Internal Medicine (Licence: CO DR.0067412) | |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2026-08-26 |