| NPI | 1316169964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 4301093798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101244303) |
| 207R00000X Internal Medicine (Licence: MI 4301093798) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116017454) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2012-08-08 |