| NPI | 1962760447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology (Licence: VA 0101261679) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 182672) | |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2024-07-12 |