| NPI | 1780090241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IA MD49245) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD474472) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 19791) | |
| Enumeration Date | 2014-07-05 |
| Last Update Date | 2023-03-13 |