| NPI | 1013350636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME150450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-01389) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2019-01389) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2021-08-25 |