| NPI | 1407340839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CO DR.0077577) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301115042) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2026-06-04 |