| NPI | 1265726467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PA MD451599) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT200151) |
| 207R00000X Internal Medicine (Licence: PA MT200151) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2021-07-14 |