| NPI | 1790199362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CT 65373) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2016009663) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 61389) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 65373) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2022-06-09 |