| NPI | 1225267297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 35104) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.055761) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2022-08-04 |