| NPI | 1982997342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A161537) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P9290) |
| 207R00000X Internal Medicine (Licence: WI 63692) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2023-01-06 |