| NPI | 1588808075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: VA 0101265038) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 4301102349) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301102349) | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2021-06-17 |