| NPI | 1144458399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 247060) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 240578) |
| 207P00000X Emergency Medicine (Licence: MA 247060) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2014-11-24 |