| NPI | 1972827962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 65210) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 11705) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2024-07-11 |