| NPI | 1356835474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 22943) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01085971A) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01085971A) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 66459) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2025-10-31 |