| NPI | 1447519905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CO DR.0064012) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2015-00600) |
| 207RI0011X Internal Medicine Interventional Cardiology (Licence: CO DR.0064012) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 182456) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2020-06-11 |