| NPI | 1619242815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA 454339) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.143096) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PA 454339) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2025-06-20 |