NPI | 1568585289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME112180) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 237117) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 237117) | |
Enumeration Date | 2007-04-09 |
Last Update Date | 2012-08-30 |