| NPI | 1023536620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: MA 1018509) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-09-02 |
| Last Update Date | 2024-05-29 |