| NPI | 1952899767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: ND 21872) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: LA 345095) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: TX U4911) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2025-10-31 |