| NPI | 1073711826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35124999) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 249951) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 9283) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2017-07-07 |