| NPI | 1225563463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2020-02284) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2020-02284) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2020-06-17 |