| NPI | 1588922678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 2945361) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA10271900) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 2945361) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2023-05-16 |