| NPI | 1134479629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 278177) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201936) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 278177) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2019-08-19 |