| NPI | 1255776456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL TRN24269) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01077522A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN24269) | |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2019-10-21 |