| NPI | 1033730775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA122116200) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 35159-R) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 00000) | |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2024-08-13 |