| NPI | 1033661061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA058700) |
| Additional Taxonomies | 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology (Licence: PA OA003975) |
| 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology (Licence: PA MA058700) | |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2020-08-30 |