| NPI | 1093133027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA A171671) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10197800) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 0) | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2022-07-19 |