NPI | 1841712460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: SC 83374) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3596) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-07-14 |
Last Update Date | 2020-10-14 |