| NPI | 1285835926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TX S0145) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV FC2380171) |
| 207R00000X Internal Medicine (Licence: WV 23191) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35.121677) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2022-01-04 |