| NPI | 1487829859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2015-00944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD441961) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL TRN17421) | |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2015-06-16 |