| NPI | 1124394861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 298510) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036.137563) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2019-04-11 |