| NPI | 1417121187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 67426) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 255687) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME 123438) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2018-06-12 |