| NPI | 1023211018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60569960) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD154898) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2022-02-04 |