| NPI | 1609308691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: SC 91410) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 91410) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 91410) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 271492) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2024-06-03 |