| NPI | 1447698311 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 16264) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301109481) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-12 | 
| Last Update Date | 2024-01-29 |