| NPI | 1063690717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A136114) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 53186-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2018-03-17 |