| 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 |