| NPI | 1750872297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: MN 78854) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101272245) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2025-05-06 |