| NPI | 1306230990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: WA MD60786735) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60786735) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2022-06-21 |