| NPI | 1306132774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 330550) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A137211) |
| 207R00000X Internal Medicine (Licence: AZ 49677) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A137211) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2022-11-28 |