| NPI | 1447665971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD202016) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 68770) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2021-10-05 |