| NPI | 1003074212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX P8032) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: WI 2260) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2022-10-25 |