| NPI | 1770514119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: VA 0101272158) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101272158) |
| 207R00000X Internal Medicine (Licence: NH 17520) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2026-02-20 |