| NPI | 1629363742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: ME MD22086) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 262877) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 262877) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2018-06-23 |