| NPI | 1417365438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA10417300) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101269311) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2024-11-21 |