| NPI | 1518196518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 62861) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MN 59056) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL TPME4860) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.015944) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2022-12-01 |