| NPI | 1386055622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: IL 036-159515) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD045022) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A168213) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301104851) | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2022-08-09 |