| NPI | 1386736379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: MO 2013025678) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 230469) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN 43975) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-03-13 |