| NPI | 1043638729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WI 3773) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 17954) |
| 207R00000X Internal Medicine (Licence: IL 36.165074) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2024-01-29 |