| NPI | 1891355731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 74167) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101285796) |
| 207R00000X Internal Medicine (Licence: VA 0101285796) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 74167) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351045476) | |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2025-11-04 |