| NPI | 1942716998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology (Licence: DC 161255) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: E1160515) |
| 246W00000X Technician, Cardiology (Licence: WA 60434882) | |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2019-05-03 |