| NPI | 1639494339 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: SC 40654)  | 
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: RI LP03627)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-06 | 
| Last Update Date | 2021-06-02 |