| NPI | 1821451006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 25MA10866000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI 21137) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2024-06-11 |