| NPI | 1184865982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A104497) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A104497) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A104497) | |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2016-07-26 |