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 |