| NPI | 1336397991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VT 042.0014768) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME164821) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NH 20517) | |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2025-11-10 |