| NPI | 1124331012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA 20A15505) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM R09-2014) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2022-07-21 |