| NPI | 1912435884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA12617800) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: PA MD476542) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 328163) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2025-07-14 |