| NPI | 1003300617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: NM MD2026-0339) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T5387) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NM MD2026-0339) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 276344) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2026-06-15 |