| NPI | 1821343179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: FL ME177940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.020812) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MO 2019014001) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.020812) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MO 2019014001) | |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2026-04-15 |