| NPI | 1508209354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WI 62920) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 62920) | |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2020-10-28 |