| NPI | 1013972488 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD00045084)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA 45084)  | 
| Enumeration Date | 2006-04-19 | 
| Last Update Date | 2015-06-09 |