| NPI | 1528485620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 304733) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MA 259845) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MA ET90-094) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 259845) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2020-10-08 |