NPI | 1538572219 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NJ 25MA11153900) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD462208) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT207213) | |
Enumeration Date | 2014-06-10 |
Last Update Date | 2021-08-05 |