| NPI | 1952929077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: LA 330002) |
| Additional Taxonomies | 207RI0011X Internal Medicine Interventional Cardiology (Licence: PA MD473775) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2022-03-26 |