| NPI | 1790103364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 287296) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 287296) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2022-07-21 |