| NPI | 1811569882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX 1811-56-9882) |
| Enumeration Date | 2021-07-10 |
| Last Update Date | 2024-11-14 |