| NPI | 1558865253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 25MA11811700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0013423) |
| 207R00000X Internal Medicine (Licence: DE C1-0013423) | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2023-06-15 |