| NPI | 1134570633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CT 71049) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MA 279313) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 279313) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2022-06-21 |