| NPI | 1841678547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD16321) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI lp03562) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2024-01-30 |