| NPI | 1427498674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 54828) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 256292) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2017004299) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.248725) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2021-06-10 |