| NPI | 1861621732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2017-00221) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094413) |
| 207R00000X Internal Medicine (Licence: NC 2017-00221) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301094413) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2022-01-04 |