| NPI | 1760987713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS2142) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: SC LL83555) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: SC 83555) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2024-08-14 |