| NPI | 1245792530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: NJ 25MA11480400) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: NJ 25MA11480400) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2025-07-17 |