| NPI | 1023312576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 269111) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA a117576) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-12-26 |
| Last Update Date | 2023-03-13 |