| NPI | 1942437801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101251909)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207R00000X Internal Medicine (Licence: VA 0101251909)  | |
| Enumeration Date | 2009-06-18 | 
| Last Update Date | 2024-02-29 |