| NPI | 1750567251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: KY 50807) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME104405) |
| 207R00000X Internal Medicine (Licence: CT 046360) | |
| 208M00000X Hospitalist (Licence: CT 046360) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME104405) | |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2018-03-17 |