| NPI | 1063940963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology (Licence: NJ 25MA11117800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11117800) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2025-04-03 |