| NPI | 1255380788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD00021524) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA 00021524) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ID M-4818) | |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA 00021524) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2012-08-02 |