| NPI | 1396276895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A159270) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2024-12-09 |