NPI | 1962791772 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A155737) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 54830) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-04-01 |
Last Update Date | 2021-10-21 |