| NPI | 1487826814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 48326) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY TP359) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2015-08-27 |