| NPI | 1851521892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NE 32470) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 15695) |
| 207R00000X Internal Medicine (Licence: MA 241201) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2020-07-09 |