| NPI | 1992966360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME143538) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD451002) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT192845) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2020-09-21 |