| NPI | 1891978177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60698217) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA MD.204536) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2020-12-03 |