| NPI | 1982985594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA09482900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD444060) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2014-05-06 |