NPI | 1346788155 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL OS16582) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3899) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO3899) | |
Enumeration Date | 2017-02-01 |
Last Update Date | 2020-06-01 |