| NPI | 1730611096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: WI 103174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 97235) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2025-10-20 |