| NPI | 1083090278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PA MD488866) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 00295141) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2025-06-02 |