| NPI | 1588841639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 068164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 002141) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN md0000045295) | |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2022-01-07 |