| NPI | 1336568799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2021031694) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: KS 0445035) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MD467745) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2021-08-16 |