| NPI | 1972044568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: KY 52882) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MS T3459) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2022-07-25 |