| NPI | 1386028124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NC 2021-02904) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10053923) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R78507) | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2022-07-01 |