| NPI | 1801139464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME139078) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 78274) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2019-05-30 |