| NPI | 1972990331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MI 4351039869) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.026361) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MI 4351039869) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2022-08-10 |