| NPI | 1679140008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 5151015062) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151015062) |
| 207R00000X Internal Medicine (Licence: MI 1891702833) | |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2024-06-24 |