| NPI | 1619222627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: WA MD60943943) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125061881) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2021-06-02 |