| NPI | 1699933374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 249889) |
| 207R00000X Internal Medicine (Licence: MA 249889) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2015-04-30 |