| NPI | 1124260443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME112884) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME112884) |
| 207R00000X Internal Medicine (Licence: FL ME112884) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: FL ME112884) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2018-01-31 |