| NPI | 1932562881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: NC 2023-01291) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101267290) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-05-30 |