| 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 |