| NPI | 1962996330 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 102846) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MB11795400) | |
| Enumeration Date | 2018-06-19 | 
| Last Update Date | 2025-05-05 |