| 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 |