| NPI | 1689178428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 97080) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: DC MD049218) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2026-07-14 |