| NPI | 1710353123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: AZ 65839) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10280900) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2022-08-23 |