| NPI | 1205142932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA09872300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301113122) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT204282) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2018-03-17 |