| NPI | 1477013738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OR MD230805) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD70121289) | |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2026-08-11 |