| NPI | 1861812612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: TX T5968) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IL 152784) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: CA A140612) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-20 |
| Last Update Date | 2024-02-19 |