| NPI | 1689170219 |
|---|---|
| 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: FL ME148553) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-11-13 |