| NPI | 1275615403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD00047763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 21915) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2015-06-09 |