| NPI | 1962897801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: ID 8271083) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CO DR.0063125) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2025-11-14 |