| NPI | 1669710638 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MB09655000) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MB09655000) | |
| 207R00000X Internal Medicine (Licence: NJ 25MB09655000) | |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2017-01-12 |