| NPI | 1912325242 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN MD60615)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207R00000X Internal Medicine (Licence: TN 60615)  | |
| Enumeration Date | 2014-04-03 | 
| Last Update Date | 2025-01-28 |