| NPI | 1639382898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101245484) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116018304) |
| 207R00000X Internal Medicine (Licence: VA 0101245484) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2016-05-19 |