| NPI | 1548847015 |
|---|---|
| Former Name | RYAN CHRISTOPHER SMITH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036170233) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036170233) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 390200000x) | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2024-11-22 |