| NPI | 1336521830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL 153884) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 153884) |
| 207R00000X Internal Medicine (Licence: CT 69916) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: IL 125067688) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL 153884) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2026-06-01 |