| NPI | 1245676493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO DR.0064747) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 9169323-1205) |
| 208M00000X Hospitalist (Licence: UT 9169323-1205) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2020-06-10 |