| NPI | 1902981871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 241066) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD429478) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VT 042.0013217) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT189586) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2015-08-14 |