| NPI | 1205215977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VT 042-0016283) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL0005594) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2022-10-11 |