| NPI | 1699186064 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 324091)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 56907)  | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 3902000000X)  | |
| Enumeration Date | 2014-05-19 | 
| Last Update Date | 2024-10-08 |