| NPI | 1902848377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 60815-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2004015133) |
| 208000000X Pediatrics (Licence: MO 2004015133) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2004015133) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MO 2006025337) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2013-07-31 |