| NPI | 1679936603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 073593) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101024659) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 19293141008) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-08-14 |