| NPI | 1083169742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 310650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 268285) |
| 207R00000X Internal Medicine (Licence: NY 310650) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 268285) | |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2021-07-27 |