| NPI | 1962039693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VT 042.0018515) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 336917) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-06-13 |