| NPI | 1811215296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NY 270824) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NY 270824) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 490646869) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2019-04-17 |