| NPI | 1447559604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: GA 080884) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208D00000X General Practice (Licence: LA MD.205849) | |
| Enumeration Date | 2011-03-26 |
| Last Update Date | 2019-01-25 |