Patient Types: Coronary artery disease, STEMI, cardiogenic shock, complex total occlusions, diagnostic Cath procedures, valvular disease, renal disease, carotid stenosis, limb salvage, peripheral stenosis, thrombosis disease, Impella insertion, LVAD insertions, etc. Skills required: Critical patient assessment skills, Vasoactive and Sedation drug administration, sterile technique, air management, Laser and Lithotripsy Atherectomy, Cardiac Cath lab and Peripheral IV skills.