| NPI | 1710220611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2016-0485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM RS2013-0335) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2013-0335) | |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2024-12-09 |