| NPI | 1083938906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA A126376) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A126376) |
| 207R00000X Internal Medicine (Licence: OH 35.120620) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2020-10-16 |