| NPI | 1932385028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101249951) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MD187963) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101239951) | |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2021-11-29 |