NPI | 1669743118 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 36422) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 57047) |
208M00000X Hospitalist (Licence: MN 57047) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ PERMIT ONLY) | |
Enumeration Date | 2012-01-14 |
Last Update Date | 2024-07-07 |