| NPI | 1124472683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 318762) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD478818) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2022-10-17 |