| NPI | 1043714975 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WI 85733-20) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4301504514) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4301504514) | |
| Enumeration Date | 2018-03-23 | 
| Last Update Date | 2025-09-10 |