| NPI | 1568845147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 79458) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: GA 79458) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2024-11-14 |