| NPI | 1104083260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology (Licence: MO 2016013255) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: KS 04-38842) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MO 2016013255) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2018-07-06 |