| NPI | 1922445055 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: MA 270650) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 256000) | 
| Enumeration Date | 2013-05-30 | 
| Last Update Date | 2022-11-29 |