| NPI | 1619562295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 55923) |
| Additional Taxonomies | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: ID 55923) |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2023-03-15 |