| NPI | 1023407806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MT MED-PHYS-LIC-100894) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML60651688) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60864977) | |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2022-10-05 |