| NPI | 1588078265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME162053) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX S3149) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN19764) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2023-10-06 |