| NPI | 1518242957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2020040841) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-17433) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2021-06-30 |