| NPI | 1063480655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD60021469) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: UT 4963061-1205) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2026-06-14 |