| NPI | 1497918213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD470906) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA 131295) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2021-07-21 |