| NPI | 1700058195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD446086) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 232211) |
| 207R00000X Internal Medicine (Licence: PA MD446086) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2012-11-09 |