| NPI | 1255591020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: CA 110961) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: VA 0101250262) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 258686) | |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2026-07-31 |