| NPI | 1093832404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD439620) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD439620) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301084192) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2012-10-10 |