| NPI | 1982123501 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MB10854700) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MB10854700) | |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2023-08-09 |