| NPI | 1699066001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: GA 80200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2017-00074) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: GA 80200) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 172809) | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2020-07-20 |