| NPI | 1194013425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2018017496) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 62022-20) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 2011018675) | |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2021-12-09 |