| NPI | 1093120289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2017-0225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-09132) |
| 207R00000X Internal Medicine (Licence: MO 2014016551) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM MD2017-0225) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2024-03-05 |