| NPI | 1780093831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology (Licence: MS 29614) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-08-03 |
| Last Update Date | 2022-06-23 |