| NPI | 1881960037 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 274883)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: RI MD15347)  | 
| 207R00000X Internal Medicine (Licence: RI MD15347)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-31 | 
| Last Update Date | 2022-05-18 |