| NPI | 1144547001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: LA 205979) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: LA MD.205979) | |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2023-10-26 |