| NPI | 1992904718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME108802) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME108802) |
| 207R00000X Internal Medicine (Licence: PA MD434850) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2022-06-30 |