| NPI | 1578729406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME132123) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.099540) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: LA 301968) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV LL1917) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2022-01-04 |