| NPI | 1659937696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: PA OT025456) |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2026-06-23 |