| NPI | 1972130912 |
|---|---|
| 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 1021380) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-12-02 |