| NPI | 1952472425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA 2OA13770) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00588500) |
| 207R00000X Internal Medicine (Licence: CA 2OA13770) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2018-08-27 |