| NPI | 1437507225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 70659) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03723) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2022-06-16 |