| NPI | 1942725544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME176907) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 98012) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 75291) | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2025-09-17 |