| NPI | 1821404518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NE 33457) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 59490) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OK 32744) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-08-11 |