| NPI | 1790199727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2021046760) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 259869) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2026-07-10 |