NPI | 1063091940 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 1023602) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.150785) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-04-07 |
Last Update Date | 2025-06-23 |