| NPI | 1154779858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WI 75444-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018689A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 297650) | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2021-07-15 |