| NPI | 1568729606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX BP20065443) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2022-01-07 |