| NPI | 1003120866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ME MD21010) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 18981) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2021-03-02 |