| NPI | 1184808354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ND 13971) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND PT13971) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SD 8311) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: ND 13971) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116023347) | |
| 207R00000X Internal Medicine (Licence: WV 22916) | |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2022-06-10 |