| NPI | 1780979799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: UT 11235975-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301099075) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2021-11-18 |