| 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 |