| NPI | 1760865596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: AZ 64955) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: MI 4301503549) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018528A) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2022-06-22 |