NPI | 1639563851 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME147951) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-03-25 |
Last Update Date | 2021-04-29 |