| NPI | 1407352685 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD484117)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT222983)  | 
| Enumeration Date | 2018-04-05 | 
| Last Update Date | 2024-09-04 |