| NPI | 1649775388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OR MD205017) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-08-15 |