| NPI | 1710397393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL MR155891) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL MR155891) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2022-09-01 |