| NPI | 1558673251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME119273) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: FL ME119273) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN#15335) | |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2019-09-06 |