| NPI | 1679924369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: VA 0101284516) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2025-07-30 |