| NPI | 1770978066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME163408) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 280655) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MA 280655) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2026-02-09 |