| NPI | 1952805111 |
|---|---|
| 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: MA 291782) |
| 207R00000X Internal Medicine (Licence: IL 125072230) | |
| 207R00000X Internal Medicine (Licence: IL 036157157) | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2022-08-10 |