| NPI | 1407146962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: MA 281128) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: RI MC16299) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2023-04-24 |