| NPI | 1891104915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036.152193) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.130210) |
| 207R00000X Internal Medicine (Licence: IL 036.152193) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2024-01-29 |