| NPI | 1679062707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A167388) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A167388) | |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2022-11-28 |