| NPI | 1508247560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 325831) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-2977) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MS 25585) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-09-09 |