| NPI | 1649437583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: PA MD461184) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 10928) |
| 207R00000X Internal Medicine (Licence: NY 257998) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2020-08-31 |