| NPI | 1043732415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD61343735) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61343735) |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: WA MD61343735) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2023-05-16 |