| NPI | 1356873012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 305489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 305489) |
| 207R00000X Internal Medicine (Licence: MI 5315213109) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VA 0101286538) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5315213109) | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2025-07-12 |