| NPI | 1720159890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2010-0485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME EC-06-1072) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NM MD2010-0485) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2018-03-17 |