| NPI | 1043506884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PA MD468748) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NC 2018-01098) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2022-11-16 |