| NPI | 1649616582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01081233A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301102811) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036.139760) | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2025-11-10 |