| NPI | 1972874931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A124714) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: NJ 25MA09071700) | |
| 207R00000X Internal Medicine (Licence: CA A124714) | |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2022-02-04 |