| NPI | 1235623810 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: NJ 25MB11110400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB11110400) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT018437) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2024-09-04 |