| NPI | 1780145771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MS 31621) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MS 31621) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2025-10-29 |