| NPI | 1992151138 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL OS18926) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS18926) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-06 | 
| Last Update Date | 2023-01-31 |