NPI | 1356906135 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IA R-12554) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-05-07 |
Last Update Date | 2022-06-04 |