NPI | 1184019143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 291669) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 291669) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 276861) | |
Enumeration Date | 2015-04-06 |
Last Update Date | 2025-05-15 |