| NPI | 1770780108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: LA MD.203639) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019663) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-09-28 |