| NPI | 1932347820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MD D72536) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: NJ 25MA08641200) | |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2024-03-21 |