| NPI | 1205275526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: NY 289462) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 289462) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: NY 289462) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 572841215) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2021-12-03 |