| NPI | 1720583099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101027952) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 5101027952) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-06-17 |