| NPI | 1417273061 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: TN 57222) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 127786) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-07 | 
| Last Update Date | 2018-08-20 |