| NPI | 1790281491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology (Licence: NC 2026-01962) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2026-08-07 |