| NPI | 1003839093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60260896) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NE 23017) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2015-07-14 |