| NPI | 1669622262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD478784) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 235722) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT AS-1559650-S395) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2023-08-02 |