| NPI | 1063155794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 84353-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 390200000X) |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2024-08-12 |