| NPI | 1164606448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AZ 505941) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MS 23004) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: LA MD206266) | |
| Enumeration Date | 2007-12-22 |
| Last Update Date | 2017-10-03 |