NPI | 1184112591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA11134400) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 276935) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-05-01 |
Last Update Date | 2021-08-22 |