| NPI | 1861806580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IN 01084363A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11017937A) |
| 207R00000X Internal Medicine (Licence: IN 01084363A) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2025-03-06 |