| NPI | 1376731406 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: FL ME128741) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207R00000X Internal Medicine (Licence: TN 47243) | |
| Enumeration Date | 2007-10-15 | 
| Last Update Date | 2016-08-29 |