NPI | 1265069272 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA11826900) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD481883) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-27 |
Last Update Date | 2023-08-10 |