| NPI | 1508204405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OR MD220166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 310798) |
| 207R00000X Internal Medicine (Licence: TX R2396) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301103473) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2024-10-28 |