| NPI | 1215496427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA A177303) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A177303) |
| 207R00000X Internal Medicine (Licence: CA PTL915) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2022-07-13 |