| NPI | 1285954958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NC 2015-01039) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101253595) |
| 207R00000X Internal Medicine (Licence: NC 2015-01039) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2021-05-03 |