| NPI | 1689081069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2021012941) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2021012941) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2021-08-12 |