| NPI | 1346509700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: FL 158050) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101257237) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 0101257237) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2015-0032) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2023-01-28 |